Therapeutic Exercise Program Research Articles

Analysis of Dry Needling Combined with an Exercise Program in the Treatment of Knee Osteoarthritis: A Randomized Clinical Trial

Background: Therapeutic exercise is recommended for people with knee osteoarthritis (OA), although it could be complemented with other treatments such as dry needling (DN). The purpose of this study was to evaluate and compare the resulting data on pain, functionality, strength and range of motion in subjects with knee osteoarthritis after being treated with a specific therapeutic physical exercise program alone or in combination with the DN technique in the popliteus muscle. Methods: A total of 33 participants were randomly assigned to two groups: the dry needling plus therapeutic physical exercise group (n = 15) and the therapeutic physical exercise alone group (n = 18). Both groups received the same exercise protocol, and the dry-needling group conducted three sessions of this technique over 3 weeks. Results: Variables such as pain, functionality, neuropathic pain, stiffness, strength, range of motion, pain catastrophizing and kinesiophobia were evaluated before and after the intervention, as well as at a follow-up 3 months after the intervention. Significant differences were observed between the two groups in pain intensity, stiffness, functionality, pain catastrophizing and kinesiophobia (p < 0.001). Conclusions: The combination of dry needling targeting the popliteus muscle and therapeutic physical exercise showed better results in terms of pain, functionality and strength compared to therapeutic physical exercise alone, especially after the intervention.

Effectiveness of virtual-walking intervention combined with exercise on improving pain and function in incomplete spinal cord injury: a feasibility study.

A feasibility pilot study. To assess the feasibility a full-scale Randomized Controlled Trial aimed at assessing the beneficial effect of a Virtual Walking (VW)-based (Experimental intervention (EI)) on neuropathic pain and functionality in people with incomplete spinal cord injury (SCI). A hospital service (Hospital Universitario y Politécnico La Fe) and disability associations (TetraSport, CODIFIVA and ASPAYM). Twelve people with chronic incomplete SCI were randomized to EI (VW plus therapeutic exercise program (TE)) -or Control Intervention (CI (placebo VW and TE)) groups. A six-week intervention (3 sessions/week) was carried out. To assess feasibility, the following outcomes were used: level of restriction and validity of inclusion and exclusion criteria, participants' compliance, accessibility and acceptability of the intervention for participants, adequate pre-training time of physiotherapists. To explore therapy effectiveness, pain severity, and interference, mean and maximum isometric strength, walking speed, and walking ability were assessed before (Time 1, T1) and after (Time 2, T2) the intervention. 20% of the participants initially recruited did not meet inclusion criteria. In addition, all participants completed at least 80% of the intervention sessions and none of the participants dropped out before T2. No serious adverse event was found. Moreover, 91.67% of participants were willing to perform the intervention again and all therapists involved were adequately pre-trained. Finally, our preliminary results suggest that the proposed EI is effective. A full-scale RCT is feasible and preliminary results suggest that VW with TE could have a beneficial impact on pain and functionality in this population.

The impact of cavaletti height on dogs' walking speed and its implications for ground reaction forces.

The objective of this study was to investigate the effects of cavaletti pole height on temporospatial (TPS) and ground reaction force (GRF) variables as compared to a walking gait in healthy dogs. A total of 25 client-owned dogs were included in this study. This study used client-owned dogs to explore the effects of cavaletti pole height on TPS and GRF variables. Dogs were first walked over a validated pressure-sensitive walkway (PSW) and then walked over the PSW over which six cavaletti poles were set. Cavaletti pole height was initially set at 2 inches and then increased incrementally to 4 inches, 6 inches, and 8 inches. TPS and GRF variables were obtained for all dogs walking across a PSW without cavaletti poles and at each cavaletti height. TPS variables were then compared to those obtained at a normal walking gait. Increasing cavaletti height resulted in significant decreases in walking gait velocity and the number of gait cycles per minute. Conversely, significant increases in gait cycle duration (duration of one complete cycle of gait, which includes the time from the initial contact of one paw to the subsequent contact of the same paw) and gait time (duration to walk the total distance on the PSW) were noted. Increases in stance time, normalized maximum force, and normalized vertical impulse were observed. Cavaletti height does influence TPS variables in healthy dogs at a walking gait. The effects were most notable with regard to velocity. Due to the lack of consistent velocity for all cavaletti heights, no conclusions can be drawn regarding the effect of cavaletti height on ground reaction forces. Further investigation is needed to elucidate whether it is the velocity, cavaletti height, or combination of both that impacts ground reaction force variables. When selecting cavaletti pole heights for a therapeutic exercise program, an increase in cavaletti height results in a slower walking gait.

Recommended exercises for lower back pain on YouTube videos; Are they useful or harmful?

ObjectiveLow back pain (LBP), a common public health problem affecting nearly 80 % of the population, causes disability and work absence, while exercise is recommended as an adjuvant treatment. YouTube is one of the most frequently used source of information, especially by patients. The aim of the study was to analyze clinically the reliability, feasibility and the content quality of exercises videos recommended for LBP on YouTube. channel. MethodsBased on the observational study of the number of views of YouTube videos, 154 videos worth evaluation were selected using the keywords "low back pain” and “exercises",. The content quality of each video was evaluated with a) the American Medical Association Journal (JAMA), b) DISCERN, c) Global Quality Score (GQS), and d) Medical Quality Video Assessment Tool (MQ-VET) scales, while Pearson correlation analysis was performed to determine the correlation between the JAMA, GQS, DISCERN, MQ-VET scale scores. ResultsAccording to the findings, the primary source for uploading exercise videos were physicians (32.5 %), with a high content quality. There was a statistically significant positive correlation between the total scores of all quality scales and the independent variables defined as view rates and number of comments (p < .05). The analysis of the video content showed that only 35 % (n = 54) of the videos explained the risks of the recommended exercises in detail ConclusionIt can be concluded that the relability and feasibility of exercise videos for LBP on YouTube depend highly on the upload source. Thus digital content in health should be created with a multi-disciplinary team including healthcare professionals and also standardized to inform patients with the risks and benefits to avoid the potential harm due to the complex causes of low back pain. Public Interest SummaryLow Back Pain, which a major health problem, is the most common musculoskeletal disorder leading to increased medical expenses and work absenteeism, while the most appropriate intervention remains elusive.. The therapeutic exercise program might differ according to patient's age, physical condition and the severity of the disease, while sustainability of the exercise program depends on the preference of exercise type of each patient. From this perspective, it is an important advantage that different exercise videos are available on YouTube. However, the content quality and reliability of exercise videos are the discriminators for the expected outcomes, since good quality content will benefit patients and prevent possible injuries and worsening of pain.

Affordable web-based foot–ankle exercise program proves effective for diabetic foot care in a randomized controlled trial with economic evaluation

The aim of this study was to shed light on a crucial issue through a comprehensive evaluation of the cost-effectiveness and cost-utility of a cutting-edge web-based foot–ankle therapeutic exercise program (SOPeD) designed for treating modifiable risk factors for ulcer prevention in individuals with diabetes-related peripheral neuropathy (DPN). In this randomized controlled trial, 62 participants diagnosed with DPN were assigned to the SOPeD software or received usual care for diabetic foot. Primary outcomes were DPN symptoms and severity, foot pain and function, and quality-adjusted life years (QALYs). Between-group comparisons provided 95% confidence intervals. The study also calculated incremental cost-effectiveness and cost-utility ratios (ICERs), analyzed direct costs from a healthcare perspective, and performed a sensitivity analysis to assess uncertainty. The web-based intervention effectively reduced foot pain, improved foot function and showed favorable cost-effectiveness, with ICERs ranging from (USD) $5.37–$148.71 per improvement in different outcomes. There is a high likelihood of cost-effectiveness for improving DPN symptoms and severity, foot pain, and function, even when the minimum willingness-to-pay threshold was set at $1000.00 USD. However, the intervention did not prove to be cost-effective in terms of QALYs. This study reveals SOPeD's effectiveness in reducing foot pain, improving foot function, and demonstrating cost-effectiveness in enhancing functional and clinical outcomes. SOPeD stands as a potential game-changer for modifiable risk factors for ulcers, with our findings indicating a feasible and balanced integration into public health systems. Further studies and considerations are vital for informed decisions to stakeholders and the successful implementation of this preventive program on a larger scale.Trial Registration: ClinicalTrials.gov, NCT04011267. Registered on 8 July 2019.

Effect of aquatic versus conventional physical therapy program on ankle sprain grade III in elite athletes: randomized controlled trial

IntroductionAnkle sprains are the second most common sports injury after knee injuries, with about 85% of them affecting the lateral ankle ligaments. These injuries are particularly prevalent in sports like basketball and volleyball.PurposeTo investigate the effect of Aquatic therapy as an early rehabilitation protocol for elite athletes with acute lateral ankle sprain grade III on back-to-sport time, dynamic balance, pain, Athletic performance, and muscle power compared to land-based exercise training.MethodsThirty elite athletes have ankle sprain grade III with sprain onset from 1 to 7 days, their age ranges from 18–30 years old were recruited. All participants are professional athletes; mainly participating in above-head sports such as volleyball and basketball. The patients were randomly allocated into two treatment groups: Group I (control group): 15 patients received a conventional physical therapy program of structured therapeutic exercise program, manual therapy and land-based exercises, in addition to external support, and Group II (Aquatic therapy group): 15 patients received aquatic training. Visual Analog Scale (VAS) was used to measure the pain intensity, while the dynamic balance was measured by the Star Excursion Balance Test. Athletic performance was measured by HOP Tests (Single, Triple, 6-m, and Cross-over hops) aided by the Agility T-Test (ATT) and Illinois Agility Test (IAT). Muscle power was tested by a Single Leg Press. Finally, back to sports time was recorded for each participant in both groups.ResultsThere was a significant interaction effect of Aquatic therapy and time for VAS (p < 0.001), single hop (p < 0.001), triple hop (p < 0.001), cross-over hop (p < 0.001), IAT (p = 0.019) and ATT (p < 0.001) of both affected and nonaffected. There was no significant interaction effect of Aquatic therapy and time for 6-MHT of affected (p = 0.923), and nonaffected (p = 0.140). There was a significant main effect of time for all dependent variables (p < 0.001) except for 6-MHT of affected (p = 0.939), nonaffected (p = 0.109), and IAT (p = 0.099). The Star excursion dynamic balance test (SEBT) and Single leg press revealed a significant difference between groups on affected and non-affected sides (p < 0.001*). Lastly and most importantly the back-to-sport time revealed a significant difference in the return-to-sport time in favor of the Aquatic therapy group who returned faster than the control group (p < 0.001*).ConclusionAquatic therapy is more effective than traditional protocols regarding early rehabilitation of acute ankle sprain grade III in Elite professional athletes for reducing pain intensity, improving dynamic balance and athletic performance and power and accelerating their return to sports time. Because aquatic therapy produces better outcomes, it is advised to be included in the rehabilitation programs of athletic patients with acute ankle sprains grade III.

Multimodal therapeutic intervention program associated with photobiomodulation therapy for individuals with chronic nonspecific neck pain: protocol for a clinical trial

BackgroundNeck pain is a prevalent global musculoskeletal issue, significantly contributing to the loss of years of healthy life due to disability. Chronic nonspecific neck pain (CNNP) involves diverse symptoms impacting mobility and quality of life. While therapeutic exercises demonstrate efficacy, the role of photobiomodulation therapy (PBMT) remains uncertain. This study aims to assess the additional effects of PBMT within a multimodal therapeutic intervention for CNNP.MethodsA randomized, two-arm, controlled, blind clinical trial follows CONSORT and SPIRIT guidelines. Participants diagnosed with CNNP will receive a stand-alone multimodal therapeutic intervention or the same program with additional PBMT. The primary outcomes will be assessed by the functional disability identified through applying the NDI (Neck Disability Index). Secondary outcomes will be pain intensity during rest and active neck movement, catastrophizing and kinesiophobia, functionality, and disability assessed at baseline, after 8 weeks, and at a 4-week follow-up. Both groups receive pain education before personalized interventions, including resistance exercises, neuromuscular activities, mobility, and body balance. The PBMT group undergoes low-level light therapy. Intention-to-treat analysis, using linear mixed models, employs data presented as mean, standard deviation, and differences with a 95% confidence interval. Non-normally distributed variables transform. Statistical significance is set at 5%.DiscussionThis study addresses a critical gap in understanding the combined effects of PBMT and therapeutic exercises for CNNP. The findings aim to guide clinicians, researchers, and CNNP sufferers through rigorous methodology and diverse outcome assessments, offering valuable insights into evidence-based practices for CNNP management. Data confidentiality is maintained throughout, ensuring participant privacy during statistical analysis.Trial registrationEffects of adding photobiomodulation to a specific therapeutic exercise program for the treatment of individuals with chronic nonspecific neck pain, registration number: NCT05400473, on 2022-05-27.

Impact of Pre- and Post-therapeutic Exercises in Sarcopenia and Pain in Liver Transplant Patients.

Sarcopenia, a state considered by the loss of muscle function and mass, is progressively recognized as a common complication of advanced cirrhosis and is related to negative clinical consequences. Liver transplantation (LT) is one of the options in the treatment of cirrhosis. This study aimed to evaluate the impact of exercise in newly developed (ND) sarcopenia through measurement of the psoas major muscle at the level of the third lumbar vertebra by abdominal computed tomography (CT) images in liver transplant patients. This analytical case-control longitudinal study was conducted on patients aged between 16 and 70 years at King Fahad Specialist Hospital (KFSH-D) in Dammam, Saudi Arabia. The patients were divided into two groups:an intervention group consisting of liver transplant patients (LTx, n=26) and a control group consisting of end-stage liver disease patients (ESLD, n=23) who were not candidates for LT. All participants were treated with a therapeutic exercise program through three phases. The first phase included pre-operative exercises, the second phase included early post-operative exercises, and the last phase included late post-operative exercises. CT scan of the psoas major muscle was performed pre- and post-LT to assess sarcopenia. Pain was measured with a numerical pain scale before and after exercise to evaluate the impact of exercise on pain. Psoas muscle index (PMI) for post-therapeutic exercises in the control and liver transplant groups showed significant differences for both male and female patients compared with the normal range (p<0.05). The liver transplant group showed a significant difference in mean weight loss, body mass index (BMI), and numerical pain rating scale (NPRS) observed on post-therapeutic exercises compared to baseline data. Conclusion: By and large, the finding revealed a substantial impact of therapeutic exercise on patient outcomes in terms of anthropometric characteristics, abdominal pain, handgrip strength (HGS), and PMI. The mean PMI at post-therapeutic exercises showed a significant increase by measuring the psoas major muscle at the level of the third lumbar vertebra by abdominal CT, which may indicate the extent of improvement and recovery from the ND sarcopenia in LTx.The results emphasize the potential advantages of pre- and post-therapeutic exercise in LTx, including enhancements in muscle strength and mass, as well as pain management associated with liver function and general health. Optimizing patient outcomes and promoting a more comprehensive approach to liver disease treatment may be achieved by including exercise activities in pre- and post-LT care procedures.

Effects of a web application based on multimedia animations to support therapeutic exercise for rotator cuff-related shoulder pain: protocol for an open-label randomised controlled trial

IntroductionRotator cuff-related shoulder pain (RCRSP) is the most common cause of shoulder pain. Currently, exercise is proposed as the first-line treatment for patients suffering from RCRSP. However, adherence to therapeutic...

Experiences of children with bronchiectasis and their parents in a novel play-based therapeutic exercise programme: a qualitative analysis

ObjectivesTo explore the experiences and perceptions of children with bronchiectasis and their parents regarding an 8-week play-based therapeutic exercise programme.DesignQualitative study with inductive content analysis.SettingIndividual semistructured interviews were conducted. Interview...

Physical Activity and Sports for Children With Juvenile Idiopathic Arthritis.

Juvenile idiopathic arthritis (JIA) is the most common rheumatic disease of childhood, presenting clinically as inflammatory arthritis in children younger than 16 years. To date, while evidence supports physical activity for children with JIA, there is limited evidence on the recommended approach to physical activity and sports participation in this population, and no single structured therapeutic exercise program has been established as best practice. This review article presents what is known on the management of physical activity in children with JIA, including recommendations from the pediatric rheumatology and rehabilitation literature, where available, for sports participation, structured therapeutic exercise programs, and return to activity.

The effectiveness of physical therapy intervention on the quality of life in obese children and adolescents

Introduction: Physical inactivity and a sedentary lifestyle are directly linked to childhood obesity. Bad eating habits and genetic predisposition are possible factors related to its appearance. Childhood obesity has tripled in the last 3 decades. More than 340 million children worldwide are categorized as overweight or obese Childhood obesity can affect the self-esteem of young obese individuals and lead to long-term serious psychological and social consequences. Purpose: The purpose of this bibliographical review is to highlight the physical therapy intervention in the quality of life in obese children and adolescents and its interaction with other therapeutic interventions. Methodology: The search was done in MEDLINE / Pubmed, Cochrane, Embase, Scopus Studies had to be clinical studies and refer to quality of life and the use of physical therapy in obese children and adolescents. Based on the above criteria, 18 articles emerged and after applying the selection criteria, 4 articles were selected. Discussion – Conclusion: Physical therapy with therapeutic exercise programs can be a key factor in improving the respiratory function and quality of life of people suffering from obesity. Physical therapists currently provide little input into the management of children who are overweight or obese, despite having a skill set appropriate for working with this population. Physiotherapy helps to support the mobility of obese children by increasing their physical health and quality of life. There is little detail about how to get obese children "physically active" in a way that is appropriate for their development and ability.

Effect of Therapeutic Exercise in Postural Low Back Pain: A Case Report

Postural low back pain (LBP) is a non-specific LBP defined as pain or discomfort in low back areas caused by incorrect posture for ages. Most patients only experience mild and moderate pain from low back pain, however, it can cause chronic pain and disability for several groups. This case report aims to investigate the effect of therapeutic exercise on posture and pain in postural LBP. A 37-year-old male presented with LBP for 4 months with Numeric Rating Scale (NRS) 7. Physical examination showed impaired posture, wide base gait, limitation ROM of trunk, reduced breathing count test, muscle spasm at upper and lower back areas, positive in Thomas test, Ely test, and hamstring tightness test. The back pain functional scale (BPFS) was 7. The therapeutic exercise program consisted stretching exercises (neck, upper and lower back, hamstring, rectus femoris, iliopsoas muscle), core strengthening, William’s flexion, McKenzie’s, breathing and chest expansion exercise, alongside proprioceptive exercise. One cycle (eight times) of physical modalities, TENS at paralumbal and USD at paracervical, upper and middle trapezius, rhomboid, sternocleidomastoideus, paralumbal, and insertion of hamstring were given. We evaluated the patient’s condition for about 4 months, and the patient showed a good compliance with improvement in pain score, ROM of the trunk, reduced muscle spasm and tightness, improved posture, gait, breathing, and BPFS. The patient can return to do his job again. This case report is able to demonstrate that therapeutic exercise improves clinical and functional conditions. These findings suggest the clinical implications of therapeutic exercise in patients with postural LBP are beneficial.

Efficacy of aquatic vs land-based therapy for pain management in women with fibromyalgia: a randomised controlled trial

ObjectiveTo determine the efficacy of two physiotherapeutic interventions – aquatic therapy (AT) and land-based therapy (LBT) – for reducing pain in women with fibromyalgia. DesignSingle-blind, randomised controlled, equivalence trial. SettingFibromyalgia, Chronic Fatigue Syndrome and Multiple Chemical Sensitivity Association in A Coruña, Spain. ParticipantsForty women with fibromyalgia were assigned at random in a 1:1 manner to two groups: AT (n = 20) and LBT (n = 20). InterventionsTwo therapeutic exercise programmes, with 60-min sessions, were undertaken three times per week for 12 weeks. Sessions were carried out in groups by a trained physiotherapist. OutcomeThe primary outcome was pain intensity (visual analogue scale). The secondary outcomes were pressure pain threshold (algometer), quality of life (Revised Fibromyalgia Impact Questionnaire), sleep quality (Pittsburgh Sleep Quality Index), fatigue (Multidimensional Fatigue Inventory) and physical ability (6-Minute Walk Test). Patients were evaluated at baseline, 12 weeks (post-treatment) and 18 weeks (follow-up). The statistical analysis was per-protocol. P < 0.05 was considered to indicate significance. Effect size was calculated. ResultsThe mean age was 50 [standard deviation (SD) 9] years, with median body mass index of 27 [interquartile range (IQR) 25–30] kg/m2 and median symptom duration of 11 (IQR 6–15) years. No differences were observed between the groups post-treatment, but differences in favour of AT were found in pain intensity [2.7 (IQR 1.5-4.9) vs 5.5 (IQR 3.3-7.6); p= 0.023; large effect, Cohen's d= 0.8; 95% confidence interval (CI) 0.1-1.5] and sleep quality [12.0 (IQR 7.3-15.3) vs 15.0 (IQR 13.0-17.0); p= 0.030; large effect, Cohen's d= 0.8; 95% CI 0.1-1.5] at follow-up. ConclusionsThe results suggest that AT is better than LBT for reducing pain intensity and improving sleep quality after 6 weeks of follow-up. AT may be a good treatment option for women with fibromyalgia. Clinical Trials Registration NumberClinicalTrials.gov NCT02695875 Contribution of the paper•This paper provides evidence that aquatic therapy is an effective intervention for reducing pain and improving sleep quality of women with fibromyalgia.•The matched protocols designed for this study highlighted the influence of the environment on symptom management in women with fibromyalgia.

Therapeutic Play Gym: Feasibility of a Caregiver-Mediated Exercise System for NICU Graduates with Neuromuscular Weakness-A Case Series.

To describe the feasibility and effect of caregiver-mediated exercise training using a novel Therapeutic Play Gym in 3 neonatal intensive care unit (NICU) graduates with rare neuromuscular diseases. Caregivers of 3 medically complex, technology-dependent NICU graduates could not access community-based rehabilitation services after discharging from lengthy initial hospitalizations. These children, diagnosed with spinal muscular atrophy type 0, untreated X-linked myotubular myopathy, and untreated nemaline myopathy 3 (NEM3), completed monthly consultations with a pediatric clinical specialist and 3 assessment appointments. The caregivers agreed to administer a progressive Therapeutic Play Gym home exercise program at a minimum frequency of 3×/wk for 6 months. A monthly consultative approach was both feasible and effective to safely progress caregiver-mediated home exercise training using a novel Therapeutic Play Gym. Positive training effects emerged in fitness, function, and caregiver-reported quality of life domains. A strong therapist-caregiver alliance can empower families to perform guided training when community resources are limited. More research is needed to see whether this training model is feasible for children with other conditions; for use in hospital, outpatient, or educational settings; and as an adjuvant exercise treatment for children receiving disease-modifying interventions.

Sleep Quality And Body Composition Indices Of Obese Female Adolescents Improved Using Indigenous Ampe Exercise Programme

Background: Participation in the ampe exercise programme has been shown to improve the anthropometric and physiological characteristics of children, but its effectiveness on sleep quality and body composition indices of obese female adolescents is yet to be determined. This study confirms that ampe exercise programme improves sleep quality and body composition indices in obese female adolescents. Methods: The study adopted a pretest-posttest experimental design, with fifteen obese female adolescents recruited to participate in a 6-week ampe exercise programme. Before and after intervention, sleep quality, visceral fat, body mass index, and waist to hip ratio were assessed. A paired t-test and bivariate analysis were conducted between the sleep quality and body composition indices of the participants. Results: Body weight (102.33±15.80 &lt; 96.47±15.36, P=0.000), body mass index (33.55±2.56 &lt; 31.61±2.55, P=0.000), visceral fat (10.23±3.03 &lt;8.47± 2.20), (P=0.003), and waist to hip ratio (0.86±0.04 &lt; 0.83±0.05, P=0.000) decreased significantly while sleep quality (P=0.000) improved significantly after ampe exercise programme. The relationship between sleep quality and body composition indices was not significant. Conclusion: Ampe exercise programme potently improved body weight, body mass index, visceral fat, waist to hip ratio, and sleep quality in obese female adolescents. It is an effective and inexpensive therapeutic exercise programme suggested for individuals with non-communicable diseases and mental health. Further, comprehensive clinical trial studies on cardiovascular disease patients will ascertain the clinical efficacy of ampe exercise programme.

Efficacy of a Therapeutic Exercise Program on Patients' Pain and Shoulder Mobility Following Proximal Humeral Fracture Surgery

Efficacy of a Therapeutic Exercise Program on Patients' Pain and Shoulder Mobility Following Proximal Humeral Fracture Surgery

Digital Therapeutic Exercises Using Augmented Reality Glasses for Frailty Prevention among Older Adults.

The objective of this study was to investigate the effects of a digital therapeutic exercise platform for pre-frail or frail elderly individuals using augmented reality (AR) technology accessed through glasses. A tablet-based exercise program was utilized for the control group, and a non-inferiority assessment was employed. The participants included older adult women aged 65 years and older residing in Incheon, South Korea. A digital therapeutic exercise program involving AR glasses or tablet-based exercise was administered twice a week for 12 weeks, with gradually increasing exercise duration. Statistical analysis was conducted using the t-test and Wilcoxon rank sum test for non-inferiority assessment. In the primary efficacy assessment, regarding the change in lower limb strength, a non-inferior result was observed for the intervention group (mean change, 5.46) relative to the control group (mean change, 4.83), with a mean difference of 0.63 between groups (95% confidence interval, -2.33 to 3.58). Changes in body composition and physical fitness-related variables differed non-significantly between the groups. However, the intervention group demonstrated a significantly greater increase in cardiorespiratory endurance (p < 0.005) and a significantly larger decrease in the frailty index (p < 0.001). An AR-based digital therapeutic program significantly and positively contributed to the improvement of cardiovascular endurance and the reduction of indicators of aging among older adults. These findings underscore the value of digital therapeutics in mitigating the effects of aging.

Functional rehabilitation based on therapeutic exercise training in patients with postacute COVID syndrome (RECOVER)

Introduction and objectivesPostacute COVID syndrome (PACS) is common after acute SARS-CoV-2 infection. One of the most frequent and disabling symptoms is exercise intolerance (EI). Recent evidence suggests that EI in PACS has a peripheral (metabolic-neuromuscular) origin, suggesting that exercise training may be an effective treatment. The aim of this study was to assess the role a therapeutic physical exercise program (TPEP) in PACS with EI. MethodsThis single-center, open-label, randomized clinical trial compared an exercise training program (intervention group) with regular physical activity recommendations (control group) in patients with PACS and EI. The intervention group underwent an 8-week TPEP. The primary endpoint was improvement in functional capacity, assessed as the change in peak VO2. ResultsWe included 50 participants with PACS (73% women, mean age 47±7.1 years). The intervention group showed a 15% improvement in peak VO2 (peak VO2 pre- and postintervention: 25.5±7.7mL/kg/min and 29.3±4.7 mL/kg/min; P <.001) and a 13.2% improvement in predicted values (92.1±14.3% and 108.4±13.4%; P <.001). No significant changes in VO2 values were observed in the control group. Unlike the control group, the intervention group also showed improvements in all secondary outcomes: quality of life scales, muscle power, maximum inspiratory power, metabolic flexibility, and body fat percentage. ConclusionsThe program improved functional capacity in patients with PACS and EI.

The Effect of Therapeutic Adherence on the Effectiveness of a Digital Therapeutic Exercise Program: A Propensity Score Matching Analysis.

This study used a PSM model to comparatively assess the achievement of a clinically relevant pain improvement among patients who exhibit a high use (HU), intermediate use (IU), low use (LU), or sub-LU use profile. Sensitivity analyses with commonly accepted thresholds for clinically relevant improvements were conducted. Higher use profiles show a higher probability of achieving a clinically relevant improvement of self-reported pain intensities. Additionally, the achievement of any higher use level is associated with a significant increase in the probability of achieving a clinically relevant improvement. To enable the optimal effectiveness of DTx home exercise programs, an HU use profile should be pursued. This finding is in line with earlier guidance for the achievement of optimal therapeutic benefit from conventional movement and exercise therapy and underscores the importance of a cross-disciplinary effort from patients, healthcare professionals and system stakeholders alike to maximize the therapeutic effect from DTx.